THE ROLE OF THE LOOP ELECTROSURGICAL EXCISION PROCEDURE IN THE DIAGNOSIS AND MANAGEMENT OF EARLY INVASIVE CERVICAL-CANCER

The management of cervical intra-epithelial neoplasia (GIN) has evolved so that excisional techniques are now preferred over ablative procedures. This is in part due to a 1-3% rate of discovering unsuspected early invasive carcinomas that would not have been detected by ablative management of GIN. A review of our initial experience over 20 months with the loop electrosurgical excision procedure (LEEP) in treating CIN found seven out of 237 patients (3%) to have otherwise unsuspected invasive lesions. The management of three additional patients with suspected early invasive lesions has been facilitated by LEEP. The procedure has been found to produce excellent pathologic specimens and has virtually replaced traditional operative cervical conization in the management of both CIN and early invasive cervical cancer.